Uterine Massage: A New Profession?
by Mary Kroeger, CNM, MPH
© 1999 Midwifery Today, Inc. All rights reserved.
[Editor's note: This article first appeared in Midwifery Today Issue 49, Spring 1999.]
Photos by the author
For centuries, the Maya of Central America have treated women's reproductive ailments with a combination of uterine massage and realignment techniques, herbal preparations and prayer. Dr. Rosita Arvigo, noted naprapath, herbalist, author and teacher, has begun to bring this technique to North America in the hopes that more women can benefit from these techniques.
I recently had the opportunity to attend a weekend self care workshop entitled the "Arvigo Method of Mayan Uterine Massage." The workshop was held at a cozy rural conference center near Colrain, Massachusetts, set in the late summer lushness of the Berkshire Mountains. Approximately forty women, many of them practicing massage therapists, body workers, chiropractors and nurses, attended this first of a two-phase course series that, once successfully completed, provides certification in the Arvigo Massage Technique. The first is a self help course, co-taught by Dr. Arvigo and two Belizean traditional healers, Miss Hortense Robinson, a midwife and herbalist and Ms. Beatrice Waight, a village health worker. The workshop provided an introduction to participants in techniques that once mastered, will allow them to practice uterine massage on themselves. The weekend provided ample time for the trainers to teach the foundation theories behind the technique and how to conduct physical assessment of the reproductive organs. It then provided opportunity for hands-on practice for each participant, with the goal of competence in uterine massage on oneself by the end of the workshop.
The foundation premise of the Arvigo Massage Technique is that for a variety of reasons including repeated and traumatic childbirth, back injury and the chronic effects of modern lifestyle, a woman's uterus may prolapse and become misaligned in the pelvis. Dr. Arvigo maintains that this condition causes the uterus and attending organs and ligaments to be afflicted with inadequate circulation, compromised innervation and lymphatic drainage. Dr. Arvigo and her Belizean colleagues teach that with very easily learned techniques, these problems can be corrected and uterine health can be restored. To quote from her as yet unpublished book on the subject: "These Maya uterine massage techniques eliminate the primary cause of female complaints—the congested uterus, thereby preventing the progression of symptoms to chronic disease."
The weekend course began with a thorough review of female reproductive anatomy and physiology. Emphasis was placed on the "five channels of flow" in the body: the arteries, veins, nerves, lymphatics and the chi and how a dropped or misaligned uterus and attached organs can thus result in constricted circulation of blood, innervation and lymphatic drainage, causing unpleasant symptoms and disease such as dysmenorrhea (painful menstruation), irregular periods, painful intercourse, infertility, varicose veins and even uterine and vaginal infections, fibroids, polyps and cancer.
The arterial circulation, responsible for bringing what Arvigo calls the "red" or oxygenated blood to all the organs including the uterus, ovaries and ligaments, can be distorted by a misplaced uterus and result in pathology. Likewise, with the venous flow, a displaced or prolapsed uterus can restrict venous return from the pelvis; as a result, Arvigo explains, the "outward flow of toxins is reduced, and they begin to accumulate, set up pathology, and symptoms occur." She goes on to argue that this "pathology in the uterus and pelvic area results from the buildup of acid and carbon dioxide in the muscles, lymph and tissues. This in turn causes many internal systems and chemical transport mechanisms to go haywire."
In discussing the lymphatic system, Arvigo emphasizes the importance of maintaining the correct acid/base balance in the tissues. She says that the "glorious lymph system is charged with the task of keeping the acid base balance in proper order by carrying minerals that act as buffers to either raise or lower the pH as is needed from moment to moment. These minerals are calcium, phosphorous, and magnesium." Thus, she argues, if a misaligned or dropped uterus restricts lymph flow, "the tissues of the uterus become acidic and carbon dioxide oozes from the veins into the fluids, creating a domino effect of cascading pathology that translates into pain and disease." These "acidic tissues" can cause the cramping and spasm associated with, for example, painful menstruation.
A second role of the lymphatic system—in immunity and in protection from bacterial or viral infection—is also severely compromised by a uterus not in its proper place. "Lymphocytes, white blood cells, and macrophages" kill, then carry the "dead bacteria, pus, and harmful acids." If blocked they will "stagnate in the pelvic tissues and upset every physiological and chemical function that occurs thereby."
The nervous system is another partner in pelvic health or disease. The intricate chemical and hormonal regulation of the reproductive organs is mediated by the nervous system. Again, Arvigo points out the critical need for correct acid base balance to ensure optimal nerve communication via the neurotransmitters and the electrolyte exchange. As with the circulatory and lymphatic systems, the innervation to the pelvis will be compromised by a prolapsed or deflected uterus. In addition, Arvigo maintains that any past "injury to the spinal column due to a fall or a severe blow will cause scar tissue to replace connective tissue and nerve impulses to fire erratically through scarred areas." So every patient assessment should include an inquiry into the history of any back or hip injuries and then if appropriate, a naprapathic adjustment on the spot.
Chi Force: Maintaining Balance
Arvigo points out that while these four anatomic systems or channels are familiar and are traditionally taught in Western medical models, the fifth channel, or "chi force," might be new to some participants. Arvigo maintains that this fifth force is of utmost importance as well: "Chi" is a term used by the Chinese to describe the "prime fluid" or the flow of the energy of life. The human body consists of channels of energy that are believed to be formed in the embryo. "These channels are called meridians, and, just as the artery circulates red blood [sic], these meridians circulate energy through the human body. By transmitting guiding codes, the meridians regulate the flow of energy that is absorbed from the environment and transformed into biochemical energy in the cells. Our chi maintains our balance and prevents life from becoming a chaotic and undependable event. The flow of energy through the tissues of the human body regulates digestion, protein synthesis, body temperature, and the all-important acid-alkaline balance of the blood. Every disease can be traced back to a bioenergetic breakdown that has weakened cells and the defenses. The female pelvis is a powerhouse of energy transformation, the very throne of creation through which energy patterns course and flow. These are dependent on balance within the system. A displaced uterus causes a distortion in the flow of chi, creating chaos where order was meant to reign."
The training also included presentations on appropriate nutrition and exercise to enhance pelvic health and prevent disease. A balanced diet rich in fresh fruits, vegetables and grains was highly recommended along with cautions to avoid meats, poultry, eggs and dairy products that have been raised or grown with hormonal additives and toxic fertilizers. Arvigo emphasized the impact of these hormones on women's health. Her handbook states, "These hormones are known as xeno-estrogens (from foreign sources) and upset the body's normal hormonal fluctuations throughout the lunar month. The presence of excess dietary estrogens overloads the liver to the point at which it cannot break down the estrogens and they are returned to the bloodstream in full force, only to work havoc on the system."
Regular exercise was encouraged as well, with the caution that high impact aerobics, long distance running—particularly on hard surfaces—and other sports that continuously jolt and jar the pelvis are counterproductive to uterine health. Walking, swimming and yoga on a regular basis were strongly recommended. Arvigo also shared the positive results she had obtained from using belly dancing as a regular form of exercise.
The essentials of the self massage techniques were taught to all participants in a series of hands-on practice sessions throughout the weekend. In three small groups, each led by one of the co-trainers, participants received a personal assessment and a back and hip adjustment if their exam or history required. Following this, each received gentle but deep massage of the pelvic area which involved teaching the location of her uterus and the techniques to raise and recenter it and attendant organs as needed. Some individuals required the placement of a faja or external uterine support belt designed to hold the newly replaced uterus in the optimal position. Depending on the severity of the uterine prolapse or deflection to the right or left, the participant would be instructed to keep the faja on for a time period ranging from twenty-four hours or up to a month (see photos). The faja, it was explained, helps the stretched and fallen pelvic ligaments heal and strengthen and thus in time provide support without the help of the binder. The faja consists of a small, crescent-shaped pillow filled with cotton. It is applied so that it boosts the uterus, and is then held in place by several meters of cotton cloth wound around the individual's torso.
On the second day of the workshop Dr. Arvigo turned discussions to another important aspect of healing through uterine massage. She stated that in at least 10 percent of her practice in uterine massage over the years, she has found that women experience an emotional release during the massage process due to possible negative past experiences related to sexuality and reproduction. The treatment can, at the very least, bring tears and in more extreme cases may result in major emotional breakdowns, or "breakthroughs," that can be profound and even disturbing. Past incidents of rape, incest, traumatic childbirth, abortions, infertility and so forth can evoke emotions that have been in the tissues and muscles of the pelvis and may be spontaneously released when deep massage is done by a trusted practitioner whose purpose is to heal. In fact, during the course of this workshop there were several individuals for whom the massage process brought up such past issues, and one or two actually asked to be assessed and treated privately.
Arvigo likened this phenomenon of releasing emotional and psychic armor to the muscular armor rings described by the famous psychoanalyst Wilhelm Reich in the 1930s. Arvigo describes Reich as the "father of bodywork" and urged participants to read his classic work on the subject in Character Analysis. In his work, Reich identified seven different areas or bands in the body where different kinds of emotions and trauma were held in, and then eventually were manifest as physical symptoms or disease in that area. Arvigo stated that his "seventh muscular armor ring," centered in the pelvis and genitals, is precisely the area where uterine massage evokes the same shame and guilt and subsequent pain described by Reich decades ago. Arvigo warned that if the emotional breakthroughs are a result of significant prior physical or emotional trauma, it may be necessary to refer the individual for intensive counseling and/or psychoanalytic work in addition to treatment with uterine massage techniques.
Healers In Their Own Right
The weekend workshop was enriched by the openness and sisterly attitude engendered by the three co-trainers. They used many personal experiences and case studies from their practices over the years to explain how uterine massage can be used for healing. Each of the trainers, a healer in her own right, brought something unique and special to the workshop. Rosita Arvigo has become well known since the publication in 1994 of her book, Sastun: My Apprenticeship with a Maya Healer. This biographical story chronicles the path that led Arvigo and her husband and family to the Central American rainforest of western Belize, where she has lived and worked for almost twenty years. Dr. Arvigo's professional background is in naprapathy, a system of therapeutic bodywork that is an offshoot of chiropractic. She studied and graduated in 1981 from the Chicago National College of Naprapathy. Prior to this formalized study, however, Rosita had already learned a great deal about healing herbs while she was living and farming for eight years in a remote village in Guerrero, Mexico. In Sastun she tells us that "since the closest government health clinic was an arduous fourteen hour walk through steep hills and raging rivers," she, along with the villagers, came to rely on the "centuries-old formulas of herbal teas, baths, powders and salves to meet their health needs."
Two gifted Belizean healers co-trained with Rosita. Ms. Hortense Robinson has been a colleague of Rosita for over ten years. Miss Hortense, as she is known in Belize, has been a practicing midwife and herbalist for nearly fifty years. She was delivered at home by her Mayan grandmother in 1928 in Cozumel, Mexico. She attended her first birth at age thirteen and continued with her calling to the present time. Miss Hortense's family moved to Belize when she was fifteen. Her father was a Belizean chiclero who moved the family from one chicle camp to the next while he worked gathering the sap used to make chewing gum. This environment allowed Hortense to grow up in the rainforest and learn about the plants and trees in their natural state, as well as learn their medicinal and healing uses from her mother and grandmother. She never went to school or received formal medical training.
Now living near the main port, Belize City, in the village of Ladyville, Miss Hortense at seventy years old continues to have an active practice. She estimates she has delivered thousands of babies and now delivers the grandchildren of babies she delivered long ago. Although foremost a midwife, Miss Hortense treats venereal diseases, lung problems, asthma, diabetes, arthritis, internal tumors and rheumatic heart. Her deep belief in the power of prayer and in the power of simple "goodness" as she puts it, is what makes Miss Hortense a natural healer.
Miss Beatrice Waight, the second co-trainer, is a traditional village healer from the remote village of San Familia in the Cayo District of western Belize. She too learned most of her herbology and massage practice from her Mayan relatives and she treats a wide variety of ailments among her fellow villagers. Miss Beatrice had also been formally trained by the Ministry of Health of Belize as a village health worker and has learned additional allopathic skills such as administering intramuscular injection and intravenous infusion.
I had the opportunity to closely observe Miss Waight during one of the small group practice sessions in which she did an extraordinary hands-on healing. This particular participant had given Miss Beatrice no prior history. With the participant lying on a massage table, Miss Beatrice first took her pulses, then immediately explained that she felt profound susto or evidence of a past fright. She went on to perform the uterine assessment and massage and elicited tremendous tearful release from this patient. Miss Beatrice continued working deep on this woman's pelvis, lifting and aligning her uterus, all the while quietly saying prayers in Spanish and Mayan. Beatrice then asked one of the bystanders to go outside to find marigold flowers. There were none outside, so another wild herb, motherwort, was gathered and Miss Beatrice made a dry poultice and laid it over the woman's heart. Speaking quietly in Spanish, the young patient then explained to Beatrice that she has suffered from endometriosis since a teenager, and that she also had been a victim of sexual abuse as a young girl. The atmosphere around this small group was extraordinarily focused and the love and energy moving from Beatrice to this young woman was palpable by those of us who were observing. Beatrice gave further instructions to the young woman on her diet, helpful herbs and daily regime of uterine massage. As with each of the participants that weekend, this woman left the workshop with her own set of new skills that would help her continue her own self healing.
The follow-up workshop scheduled for late in 1998 in Santa Fe, New Mexico was designed for professionals who planned to use the technique in their practice. Requirements for this second course included completion of the self care course and licensure in the United States in a health or allied health profession. This licensure can include massage therapists, chiropractors, naprapaths, naturopaths, acupuncturists, medical doctors, midwives and nurses. The course brochure describes the five day training as including "a review of anatomy and physiology of the abdomen, demonstration of bodywork adjustments for uterine health, relevant herbal and nutritional applications, conducting an intake questionnaire, contraindications, side effects, emotional responses, and return visits. A practicum will be conducted during which Rosita will work individually to teach and evaluate technique. In addition, students will be asked to complete fifty case studies with clients. This assignment must be submitted for evaluation within eighteen months of completing the professional training sessions. Reading and essay assignments will also be given. After completing the above, an additional five day session will be held during which case histories will be discussed, questions answered and the student's massage technique evaluated. Upon successful completion of this final training (especially approval of all requirements by Dr. Arvigo), the student will be certified in the ‘Arvigo Massage Techniques.’"
This professional training is designed to be rigorous and thorough. Arvigo is requiring that only licensed practitioners attend the course in order to avoid any legal or professional concerns related to provision of hands-on care. To date there have been only two self care trainings in the United States; the professional course took place for the first time ever in the United States in late 1998. There is growing interest in the technique and many more workshops are planned both in the United States and in Belize. Dr. Arvigo and her associates anticipate that this uterine massage technique will rapidly become popular in North America both as a self help modality and as an emerging profession in its own right.
Many Western allopathic practitioners may question the long-term effectiveness of uterine massage as a cure for uterine prolapse, dysmenorrhea or lower back pain. Some are likely to be even more skeptical about Arvigo's claims that uterine fibroids, endometriosis and chronic infertility can be mitigated by the Arvigo Massage Technique. On the other hand, Dr. Rosita Arvigo's uterine massage, as well as the dietary and lifestyle changes, have centuries of empirical experience and reports of success on their side. The dramatic case reports described by Arvigo, Hortense Robinson and Beatrice Waight in their workshops and in their literature all lead an open-minded practitioner to learn more for herself. Personally, as a women's healthcare provider for over twenty years, I remain undecided on the technique. One thing is for sure, however: if the technique does what it claims, gynecologists, surgeons, and producers of synthetic female hormones may need to find other means of employment!
- Arvigo, Rosita. (1998). Maya Uterine and Abdominal Massage. Pre-publication edition.
- Arvigo, Rosita, with Epstein, Nadine. (1994). Sastun, My Apprenticeship with a Maya Healer. San Francisco: Harper.
- Arvigo Techniques Professional Training Course Announcement. (October 9–13, 1998). Santa Fe, New Mexico.
- Reich, Wilhelm. 1933. Character Analysis. (1st ed). Later edition in English: 1974, 4th ed. Simon & Schuster.
Mary Kroeger, CNM, MPH, has been a nurse midwife since 1980 and holds a Masters degree in Public Health. Mary writes regularly for Midwifery Today, most recently contributing Maiden Midwives, a series of interviews with aspiring midwives. Click here for complete biography.
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